OPKO Health Inc. reported fourth‑quarter 2025 revenue of $148.5 million, surpassing consensus estimates of $138.06 million and $139.76 million from Zacks and other sources. Net loss for the quarter was $31.3 million, or –$0.04 per share, a beat of the –$0.07 estimate, driven largely by disciplined cost management amid a 19.1% year‑over‑year revenue decline caused by the sale of BioReference assets.
Revenue fell 19.1% from $183.6 million in Q4 2024, but the company’s diagnostics and pharmaceutical segments showed divergent trends. Diagnostics revenue dropped as legacy product sales contracted, while pharmaceutical product sales grew 16.8% year‑over‑year, offsetting some of the decline. Operating loss widened to $38.3 million from $33.1 million in the prior year, reflecting higher operating expenses and the impact of asset disposals.
For 2026, OPKO guided total revenue to $530 million–$560 million, below the $606.9 million reported for 2025, and forecast a net loss per share of $0.2612 for the full year. Q1 2026 revenue guidance of $125 million–$140 million signals a cautious outlook, while non‑GAAP EPS loss of $0.0606 for the quarter aligns with analyst expectations. The guidance reflects management’s concern about near‑term revenue contraction and the need to invest in the ModeX pipeline.
Management highlighted several strategic priorities. CFO Adam Logal noted the company ended the quarter with $369 million in cash and had repurchased shares, indicating confidence in the balance sheet. CEO Elias Zerhouni emphasized the Regeneron partnership, which could generate milestone payments exceeding $1 billion and recurring collaboration revenue. The company also reiterated its focus on repositioning diagnostics for profitability and advancing the ModeX therapeutic pipeline with non‑dilutive partnership funding.
Investors reacted cautiously, with the stock declining in after‑hours trading. The negative reaction was driven by the year‑over‑year revenue contraction, the widening operating loss, and the lower 2026 revenue guidance, which outweighed the earnings and revenue beats. The market’s focus on near‑term headwinds suggests that while the company’s long‑term partnerships and pipeline are promising, short‑term financial performance remains a concern.
Long‑term implications point to a company in transition. The Regeneron collaboration and ModeX pipeline offer substantial upside, but the current revenue decline and operating losses indicate that the turnaround is still unfolding. Share repurchases and a strong cash position provide a buffer, but the guidance signals that the company will need to sustain cost discipline and achieve revenue growth to return to profitability.
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